M Milosevic1, I Quirt, W Levin, A Fyles, L Manchul, W Chapman. 1. Department of Radiation Oncology, Princess Margaret Hospital and the University of Toronto, Toronto, Ontario, M5G 2M9, Canada. mike.milosevic@rmp.uhn.on.ca
Abstract
BACKGROUND: Sickle trait affects approximately 8% of the black population in the United States and up to 40% of individuals in some parts of tropical Africa, but rarely causes clinically significant illness. This report provides the first conclusive evidence that erythrocytes in patients with sickle trait may sickle in the microvasculature of solid tumors, leading to impaired perfusion and hypoxia. CASE: A black woman who was sickle trait positive presented with stage IIIB squamous cell carcinoma of the cervix. A biopsy showed extensive intravascular sickling of erythrocytes. An aspirate of blood obtained directly from the tumor also showed numerous sickled cells. A peripheral blood smear was normal. Direct measurement of oxygen tension using the Eppendorf electrode revealed the tumor to be markedly hypoxic, with 93% of a total of 142 individual oxygen reading <5 mm Hg. CONCLUSIONS: Erythrocytes in patients with sickle trait may sickle in the microvasculature of solid tumors and contribute to reduced blood flow and the development of hypoxia. Hypoxia is a strong independent prognostic factor in patients with cervix cancer, and further study is needed to evaluate the impact of intratumoral sickling on long-term outcome. Copyright 2001 Academic Press.
BACKGROUND: Sickle trait affects approximately 8% of the black population in the United States and up to 40% of individuals in some parts of tropical Africa, but rarely causes clinically significant illness. This report provides the first conclusive evidence that erythrocytes in patients with sickle trait may sickle in the microvasculature of solid tumors, leading to impaired perfusion and hypoxia. CASE: A black woman who was sickle trait positive presented with stage IIIB squamous cell carcinoma of the cervix. A biopsy showed extensive intravascular sickling of erythrocytes. An aspirate of blood obtained directly from the tumor also showed numerous sickled cells. A peripheral blood smear was normal. Direct measurement of oxygen tension using the Eppendorf electrode revealed the tumor to be markedly hypoxic, with 93% of a total of 142 individual oxygen reading <5 mm Hg. CONCLUSIONS: Erythrocytes in patients with sickle trait may sickle in the microvasculature of solid tumors and contribute to reduced blood flow and the development of hypoxia. Hypoxia is a strong independent prognostic factor in patients with cervix cancer, and further study is needed to evaluate the impact of intratumoral sickling on long-term outcome. Copyright 2001 Academic Press.
Authors: Helen Swede; Biree Andemariam; David I Gregorio; Beth A Jones; Dejana Braithwaite; Thomas E Rohan; Richard G Stevens Journal: Genet Med Date: 2014-08-21 Impact factor: 8.822
Authors: David S Terman; Benjamin L Viglianti; Rahima Zennadi; Diane Fels; Richard J Boruta; Hong Yuan; Mathew R Dreher; Gerald Grant; Zahid N Rabbani; Ejung Moon; Lan Lan; Joseph Eble; Yiting Cao; Brian Sorg; Kathleen Ashcraft; Greg Palmer; Marilyn J Telen; Mark W Dewhirst Journal: PLoS One Date: 2013-01-09 Impact factor: 3.240